Our Role in Advancing Population Health Management

Face-to-face care management at pharmacies and retail clinics can help support the primary care physician in an integrated health care system

Prescription pill bottle with ScriptPath prescription labels
VIDEO (3:17)
April 13, 2018
Former Executive Vice President and Chief Medical Officer, CVS Health

Health care costs continue to rise, making affordability a major concern even for insured members. Integrating the services of CVS Health pharmacists and nurse practitioners into a patient’s health care team can help improve quality of care, especially for those members with chronic conditions, and lower costs for both members and payors. Seamless, digital data sharing across all stakeholders in the care team, including physicians and nurse case managers, can ensure everyone is fully informed at all times about a patient’s condition and progress.

MinuteClinic offers tests and can conduct follow-up with a member who has hypertension and diabetes. During a visit, a nurse practitioner could confer with the member on the prescribed medication regimen and counsel them about adherence and how lifestyle changes could help better manage the condition. Information about the visit would be entered into the member’s medical history, which is shared with the referring primary care physician, any care coordinator and other members of the patient’s care team. This system of complementary primary care can be easily integrated with the medical home and accountable care organizations, and actually relieves some of the pressure on individual physician offices to coordinate care for more complicated patients.

One way we are already doing this, and moving toward true, seamless interoperability, is through real-time benefit information. We now have member-specific prescription benefit information available across all points of care – the prescriber’s office, CVS Pharmacy locations, and directly to the member through the CVS Caremark app and online, as well as through our Customer Care representatives. This ensures that everyone can see, in real-time, whether a drug being prescribed is covered under the member’s specific formulary, cost for the drug and up to five clinically equivalent therapeutic alternatives, as well as whether the pharmacy chosen is in-network. This helps ensure that members get access to the right therapy at the lowest cost.

View more 2018 Forum highlights here.

How much could better care management reduce downstream costs for members with chronic conditions? Ask Us
VIDEO (3:17)
April 13, 2018
Former Executive Vice President and Chief Medical Officer, CVS Health

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